Archive for the ‘Mercy Health Plans’ Category

If you’ve done any kind of cost analysis on your health insurance lately, you probably know that you are paying a lot more for less coverage. I know that was the case for my family. According to NBC News’ Maggie Fox in the article “Health insurance: US paying more for less, report finds,” premiums and deductibles have been increasing while coverage has declined. Personally, our deductibles and co-pays have been increasing for years at the same time as less of our health care costs are covered. Oh and our premiums have gone up too. In the last eight years, health insurance premiums have actually increased 60%, according to the non-profit Commonwealth Fund. Within eight years, average family health insurance premiums are estimated to be $25,000 a year.

Expenses rising are the main reason for the rising costs across the board. But many of these rising expenses are unnecessary. There is a ridiculous amount of waste in the industry. An Institute of Medicine estimate in 2009 showed $750 billion wasted on unneeded administrative costs, services that are not necessary, fraud, and other expenses. Both the private and public health insurance markets have to work to lower costs through better coordination of care, little to no duplication of services, and lowering administrative costs. As sort of a double whammy on Americans, as their health insurance costs increased, their wages either stayed the same or increased at a lower level. Most households have seen the percentage of their income taken up by health care expenses increase over the past eight years.

Adding fuel to the fire, many Americans have lost their jobs, and therefore their employer health insurance, in this same time frame. Families are going into the insurance market on their own and comparing quotes from companies like Mercy health plans. Only 55% or so of Americans have an employer-sponsored health insurance plan, leaving millions of Americans uninsured. The Affordable Care Act is hoping to take some of the uninsured Americans out of the market by getting them better access to affordable health insurance, but the ACA has its opponents. Some right wingers are worried that expenses will rise even further with the Affordable Care Act. Regardless of what terms are used or who is supportive, the industry as a whole needs to work to eliminate this waste and lower expenses for health insurance. It will simply not be good if everything but coverage keeps on rising.

Recently I blogged about a Wall Street Journal article stating that McDonald’s was worried it would have to discontinue offering its hourly employees “mini-med” plans because of President Obama’s health care reform bill. According to ABC News’ Daniel Arnall and Huma Khan, McDonald’s denies any truth to that story in “McDonald’s Fights Back Against Report it Will Drop Health Care Plan.” The so-called “mini-med” plans allow McDonald’s employees to receive limited medical coverage at a very low cost. While McDonald’s did ask the government to compare health insurance and determine if they could have an exemption to the new MLR (medical loss ratio) requirements, a denial of that request does that mean that McDonald’s will stop offering the plans.

The MLR requirements mandate that 80-85% of the premium amount collected go to pay for medical care, rather than administrative or business costs. Due to higher employee turnover for hourly workers and low medical costs associated with mini-med plans, that number will be difficult for McDonald’s to work with. But McDonald’s and Health and Human Services Secretary Kathleen Sebelius are adamant that McDonald’s has no intentions of dropping the health insurance coverage options. Many large retailers offer similar plans through health insurers like Mercy Health Plans where employees pay from $14 to $32 per week for basic yearly coverage up to $10,000. While the NAIC says that no exemptions will be offered for MLR requirements, the government points out that requirements haven’t yet been set in stone and everyone will have access to affordable health coverage.

As of today, college students and their parents have a lot to look forward to regarding the health insurance changes going into effect. Health Insurance Sort published a news article regarding the changes entitled “What health care reform means for students.” Students will compare health insurance costs since they can now stay on their parents’ insurance plans until the age of 26. Many students have gone without health insurance after being kicked off of their parents’ plans at age 23. This new health care reform is part of President Obama’s Health Care Reform Bill of 2010.

Health Insurance Sort’s article clears up misconceptions with the law and explains to college students and their parents how they will be affected now that this provision has taken effect. Some insurance companies opted to follow the new law as soon as it was passed rather than waiting until today’s deadline. As of today, everyone from Fallon Health Insurance to Mercy Health Plans will be covering college students longer. You will learn about how students’ privacy will be protected, what happens when a student goes to college out of the service area, if employer-sponsored plans will see an increase in premium cost, who may not be eligible, and when purchasing a basic plan from the college may be more beneficial from this article.

According to The Vancouver Sun, “Baby boomers have unique dental problems.” The article, by Julie Beun of Canwest News Service, highlights the increased problems with exposed gums, tooth root cavities, and tooth sensitivity as we age. It’s important to look to Mercy Health Plans or another health insurer to ensure that you have dental insurance as you age. While taking care of your teeth at a young age may be the best defense, having dental insurance so that you can see the dentist regularly and fix any problems is crucial.

As the life expectancy increases in most countries, so too do the amount of health and dental problems that people haven’t had to worry much about. The longer you have your teeth and use them, the more susceptible you are to dry mouth, exposed gums, tooth root cavities, and sensitivity. Through improved home and office dental care and orthodontics people are able to maintain great teeth. It is the gums, however, that are not aging as well.

Many problems are caused by vigorous brushing that pushes the gums up, exposing the tooth root. Improper diet and grinding lead to tooth and gum problems as well. The best way to prevent a lot of these problems is by using a soft or extra-soft toothbrush at home. Dentists can use coatings, bonding, desensitizers, root canals and other procedures to help with more advanced problems. The use of flouride through water, toothpastes, and mouthwashes is very helpful as well. Listerine Total Care for Sensitive Teeth was developed specifically for aging teeth.

Lawmakers in the House and Senate are hoping to make it mandatory for insurance companies to cover infertility treatments. In The Washington Times article “Insurance-plan coverage for infertility urged,” Cheryl Wetzstein says that Resolve: The National Infertility Association is pushing for the insurance coverage. Florida Representative Debbie Wasserman Schultz is cosponsor of a bill requiring insurance companies to cover clients’ infertility treatments. Fifteen states already require insurance companies like Mercy Health Plans to cover the treatment needed by 1 in 8 couples trying to conceive. Maryland and West Virginia are two of the states that already have infertility coverage.

In the Senate, Kirsten Gillibrand of New York has a companion bill on the table. Resolve is also hoping that the government will allocate $1 million for a “national action plan” on infertility, which the CDC is developing. They want to learn more about what is causing infertility so that it can be detected and treated earlier. With 7.3 million women struggling either to conceive or carry a pregnancy, it is important to compare health insurance offerings from state to state and see what can be done nationally with insurance. Sexually transmitted diseases and simply waiting too long to have kids are some of the main culprits causing infertility. The more that the topic is discussed by women dealing with it, the more lawmakers and insurance companies will be forced to deal with this pressing issue.

All health insurance companies are required to extend coverage to many young adults on their parents’ policies starting September 23rd of this year. According to “Three insurers won’t drop adult children on parents’ policies” by Duke Helfand of The LA Times, some insurance companies are enacting the policy starting immediately. WellPoint, Humana, and UnitedHealthCare have made the decision to start following the new federal regulations early so that college students nearing graduation and some other young adults will not lose their health coverage. It remains to be seen whether other insurers like Mercy Health Plans will follow suit or if they’ll wait until the regulation deadline in September.

Young adults will now be able to remain on their parents health plans until they are age 26, along with some other additions to young adult coverage. Minneapolis based UnitedHealthCare and Louisville, Kentucky based Humana have already begun their continuity of coverage for young adults. UnitedHealthCare says that they will be positively affecting 150,000 people by implementing President Obama’s regulation early. Indianapolis based Wellpoint will begin extending their coverage on June 1. They’ll automatically continue the coverage of the young adults included on their parents’ plans whether they have employer-sponsored coverage or individual plans. Since many young adults can’t afford their own health insurance, the government is pleased that so many insurers are offering this extension before the deadline.

It can feel nearly impossible for small businesses to offer health coverage to their employees. A special tax credit new in 2010 can help small businesses and tax-exempt organizations provide health insurance, according to “New for 2010 – Tax credit helps small employers provide health insurance coverage,” from The Gilmer Mirror out of Dallas. The credit is included in the health care reform act, the Patient Protection and Affordable Care Act. The credit aims to help small businesses obtain or maintain health insurance coverage from companies like Aultcare and is aimed towards those employers who pay at least half of their employee’s single coverage cost. The IRS Commissioner urges small businesses and tax-exempt organizations to see if they qualify for this tax break because it is already in effect.

The current maximum credit is 35% of the premiums paid by small businesses in 2010 and 25% of the premiums paid by tax-exempt organizations that are eligible employers. The maximum credits increase in 2014 to 50% for small businesses and 35% for tax-exempt employers. The small and tax exempt employers can obtain coverage from Mercy Health Plans or any other insurance provider. This credit targets small businesses and organizations employing workers with low to moderate income levels. Typically they have to employ less than 25 full time equivalent workers earning less than $50,000 per year on average. The maximum tax credits go to businesses employing fewer than 10 full time equivalent workers, earning less than $25,000 on average. The general business credit can be redeemed starting in 2011 and the IRS is sending out postcard notifications to businesses that may be eligible.

After a year in the making, the Patient Protection and Affordable Healthcare Act has passed. Katie Adams of Investopedia describes “10 Ways the New Healthcare Bill May Affect You.” As long as they aren’t offered employer health coverage you can insure dependent kids up to age 26 now, regardless of whether or not they are in school. The age limit was 19 or 23 if they were in school. Health insurance companies like Mercy Health Plans will not be able to cancel your coverage because you get sick. It was actually common for health insurance companies to cut costs by dropping the coverage of patients who fell ill. Children cannot be denied coverage due to pre-existing conditions beginning this year. In 2014, that will apply to adults as well. Companies will no longer be able to cap the amount of lifetime coverage that patients receive, especially meaningful to people with expensive or chronic conditions.

A big change for people with pre-existing conditions that couldn’t obtain health insurance is that they will be able to purchase coverage through “high-risk pools” run by states that put a cap on your out-of-pocket expenses. By 2014, you have to carry insurance coverage from a company like Aultcare or risk getting fined. There will be government assistance for people who are not covered by employers and can’t afford coverage on their own. There will be more options for coverage in 2014 with insurance marketplaces called “exchanges”. There won’t be as much flexibility with flexible spending accounts in a few years. Fewer expenses will qualify and you won’t be able to put as much pre-tax money into your FSA. Family income greater than $250,000 will be taxed more in Medicare payroll taxes beginning in 2018. Medicare costs will be changing for many, ranging from decreases for people who use it as their primary insurance to increases for high-income people. Look for more details to come regarding the affects of the healthcare bill on you and your insurer.

In Malcolm Ritter’s Associated Press article “Study suggests too many invasive heart tests given,” the frequency of angiograms is taken into question. It is just one of the recent studies suggesting that Americans are getting too many unnecessary health tests. It is a battle between doctors and insurance companies like Golden Rule Insurance and Mercy Health Plans. Doctors are concerned about missing something and even about getting sued in some cases. For this reason, they are much quicker to order expensive tests for their patients, at a high cost to insurance companies and government programs like Medicare.

An angiogram is performed on patients who may be having a heart attack or who have shown symptoms suggesting serious blockage around the heart. They are also being frequently performed on patients whose symptoms are not as clear cut and those who have high risk traits for heart problems. To perform the test, a small tube is put in either the arm or the groin and threaded through the body to the heart. It checks for blocked arteries that could cause a heart attack by injecting dye through the tube and performing an x-ray. Almost two-thirds of the patients that didn’t have clear cut symptoms don’t have serious blockage found. Researchers believe that doctors need to do a better job determining the patients that really need these expensive tests that have risks associated with them. In order for insurance companies to function well, unnecessary and costly tests should be avoided when possible. The question now is how doctors can best treat their patients while avoiding unnecessary testing.

One of Canada’s Olympic hopefuls is 5 1/2 months pregnant, according to Yahoo! Sports’ Chris Chase. Kristie Moore is a 30 year old member of Canada’s curling team. She is only the third known pregnant Olympian, after a Swedish figure skater in the early 1900′s and a German skeleton athlete in 2006. Moore says that her pregnancy does not affect her ability to “throw rocks” just yet, although when her belly grows it just might. Her teammates have been supportive and point out that she is young and fit, which will help her in curling competitions.

I have to wonder what her insurance company thinks about her competing in the Olympics while pregnant. While companies like UPMC health insurance and Mercy Health Plans don’t have any rules against this, they may be taking on more risk with a pregnant customer competing in high level sports. Moore is an alternate so she will only actually compete if one of her team members gets injured anyways. With the Canadian women being favored to win gold in curling, Moore’s unborn baby could be the youngest team member to win a gold medal!